| NPI | 1326532565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-08209) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NC 0000000) |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2022-04-25 |